NPI | 1558715367 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 320803) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 140607) |
Enumeration Date | 2016-04-18 |
Last Update Date | 2021-06-22 |